Current Status and Determinant Factors of Telemedicine Adoption in Selected Commonwealth of Independent States (CIS) Countries; A Mix Method Study
学术急诊医学档案,
卷 14 编号 1 (2026),
1 十月 2025
,
第 e9 页
https://doi.org/10.22037/aaem.v14i1.2893
摘要
Introduction: The field of telemedicine has become an urgent innovation in the healthcare field worldwide, but there is still an unequal distribution of its implementation in transitional economies. This study aimed to evaluate the associated factors of telemedicine adoption in selected countries of the commonwealth of independent states (CIS) region.
Methods: A validated survey was used to collect data on 600 healthcare professionals, patients, information technology (IT) specialists and policymakers from selected CIS countries, using a mixed-method design. Through a designed and validated questionnaire, solid statistical techniques, and cross-regional analyses, the barriers and facilitators of telemedicine adoption in studied countries were evaluated.
Results: The general average score of telemedicine adoption was 3.84 ± 0.92. The highest mean adoption score was observed in Azerbaijan (4.02 ± 0.85), Russia (3.91 ± 0.88) and Ukraine (3.87 ± 0.91). There were significant differences between regions regarding mean adoption score (p < 0.001). Clinician acceptance (r = 0.64; p < 0.01), infrastructure readiness (r = 0.58; p < 0.01), regulatory maturity (r = 0.42; p < 0.01), and patient digital literacy (r = 0.36; p < 0.01) had the strongest correlation with telemedicine adoption. The most predictive factors of telemedicine adoption were infrastructure readiness (β (standard error; SE) = 0.42 (0.05), p < 0.001), then clinician acceptance (β (SE) = 0.39 (0.06), p < 0.001), patient digital literacy (β (SE) = 0.22 (0.05), p < 0.001), and regulatory maturity (β (SE) = 0.18 (0.04), p < 0.001). Professional experience had a minor yet significant impact (β = 0.09, t = 0.038). Logistic regression showed increased infrastructure readiness score (odds ratio (OR) = 1.48, 95% confidence interval (CI) = 1.21-1.81), clinician acceptance score (OR = 1.56, 95% CI = 1.28-1.92), regulatory maturity score (OR = 1.31, 95% CI = 1.09-1.58), and patient literacy score (OR = 1.22, 95% CI = 1.03-1.45) as the predictors of high telemedicine adoption (≥70%). The model accurately categorized 78.2% of data and the area under the curve 0.79 (95% CI: 0.75–0.83) meaning the model is a strong predictor.Conclusion: The findings showed that the structural investments cannot be made alone without the involvement of professionals. The research contributes to the existing body of transitional economies research by offering strong comparative evidence of telemedicine and provides policy recommendations on how to improve infrastructure, generate harmonization, and capacity building of clinicians and patients to support sustainable digital health ecosystems.
- Adoption
- Azerbaijan
- CIS nations
- Medical informatics
- Telemedicine
##submission.howToCite##
参考
1. AnaAnawade PA, Sharma D, Gahane S. A comprehensive review on exploring the impact of telemedicine on healthcare accessibility. Cureus. 2024 Mar 12;16(3):e55996. doi: 10.7759/cureus.55996.
2. Ezeamii VC, Okobi OE, Wambai-Sani H, Perera GS, Zaynieva S, Okonkwo CC, et al. Revolutionizing healthcare: how telemedicine is improving patient outcomes and expanding access to care. Cureus. 2024 Jul 5;16(7):e63881. doi: 10.7759/cureus.63881.
3. Omboni S, Padwal RS, Alessa T, Benczúr B, Green BB, Hubbard I, et al. The worldwide impact of telemedicine during COVID-19: current evidence and recommendations for the future. Connected health. 2022;1:7.
4. Arbaoui M. From paternalism to systemic bioethics: principles, characteristics, and contemporary relevance of applied ethics in medicine and society. Science, Education and Innovations in the Context of Modern Problems. 2025;8(12):62–69. doi:10.56352/sei/8.12.6.
5. Lestari HM, Miranda AV, Fuady A. Barriers to telemedicine adoption among rural communities in developing countries: a systematic review and proposed framework. Clinical Epidemiology and Global Health. 2024;28:101684.
6. Qizi YFU. Telemedicine in the digital era: Navigating the international legal landscape to expand global healthcare access. International Journal of Legal Information. 2024;52(2):155-65.
7. Semenova Y, Lim L, Salpynov Z, Gaipov A, Jakovljevic M. Historical evolution of healthcare systems of post-Soviet Russia, Belarus, Kazakhstan, Kyrgyzstan, Tajikistan, Turkmenistan, Uzbekistan, Armenia, and Azerbaijan: a scoping review. Heliyon. 2024;10:e29550. doi:10.1016/j.heliyon.2024.e29550
8. Ledeneva A. Commonwealth of Independent States: Armenia, Azerbaijan, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Russian Federation, Tajikistan, Turkmenistan, Ukraine, Uzbekistan. Profile Books; 2003.
9. Mammadova M, Jabrayilova Z. Electronic medicine: formation and scientific-theoretical problems. Baku:" Information Technologies" Publishing House. 2019;319.
10. Boutaghane N. Medical practice between practical dilemmas, the demand for humanization, and patient care. Science, Education and Innovations in the Context of Modern Problems. 2025;8(5):556–566. doi:10.56352/sei/8.5.55.
11. Saliba V, Legido-Quigley H, Hallik R, Aaviksoo A, Car J, McKee M. Telemedicine across borders: a systematic review of factors that hinder or support implementation. International journal of medical informatics. 2012;81(12):793-809.
12. Beebe NHF. *A Complete Bibliography of Publications in Notes and Records of the Royal Society of London. Salt Lake City, UT, USA: Nelson H. F. Beebe; 2025. Available from:https://books.google.com.pk/books?hl=en&lr=&id=snh4EQAAQBAJ&oi=fnd&pg=PT8#v=onepage&q&f=false
13. KOMI LS, CHIANUMBA EC, YEBOAH A, FORKUO DO, MUSTAPHA AY. A conceptual framework for telehealth integration in conflict zones and post-disaster public health responses. Iconic Res Eng J. 2021;5(6):342-59.
14. Reeves JJ, Pageler NM, Wick EC, Melton GB, Tan Y-HG, Clay BJ, et al. The clinical information systems response to the COVID-19 pandemic. Yearbook of medical informatics. 2021;30(01):105-25.
15. Ramasawmy M, Poole L, Thorlu-Bangura Z, Chauhan A, Murali M, Jagpal P, Bijral M, Banerjee A, et al. Frameworks for implementation, uptake and use of digital health interventions in ethnic minority populations: a scoping review using cardiometabolic disease as a case study. JMIR Cardio. 2022;6(2):e37360. doi:10.2196/37360.
16. Christodoulou I, Utomo Putranto S, Haj Youssef M, Simillidou A, Chovancová J. Strategic scaling initiatives and client networking dynamics for small and medium-sized enterprises growth: a comprehensive case study analysis. Journal of Trade Science. 2025;13(1):3-22.
17. Nazarov Z, Obydenkova A. Public health, democracy, and transition: global evidence and post-communism. Social Indicators Research. 2022;160(1):261-85.
18. Agbeyangi AO, Lukose JM. Telemedicine adoption and prospects in sub-Sahara Africa: a systematic review with a focus on South Africa, Kenya, and Nigeria. InHealthcare 2025 Mar 29 (Vol. 13, No. 7, p. 762). MDPI.
19. El Aribi AAM, Johar MGM, Khatibi A. A Multidimensional Framework for Telehealth Adoption in Libya: The Role of Trust in Technology. International Journal on Management Education and Emerging Technology (IJMEET). 2024;2(3):38-51.
20. Lee AT, Ramasamy RK, Subbarao A. Understanding psychosocial barriers to healthcare technology adoption: A review of TAM technology acceptance model and unified theory of acceptance and use of technology and UTAUT frameworks. InHealthcare 2025 Jan 27 (Vol. 13, No. 3, p. 250). MDPI.
21. Deng W, Yang T, Deng J, Liu R, Sun X, Li G, et al. Investigating factors influencing medical practitioners’ resistance to and adoption of internet hospitals in China: mixed methods study. Journal of Medical Internet Research. 2023;25:e46621.
22. Gazeau B, Zaman A, Minunno R, Shaikh F. Systemic Gaps in Circular Plastics: A Role-Specific Assessment of Quality and Traceability Barriers in Australia. Sustainability. 2025;17(14):6323.
23. Thien TH, Hung NX. Institutional pressures, legitimacy, risks, uncertainty and voluntary adoption of IFRS for SMEs in Vietnam. Journal of Eastern European and Central Asian Research (JEECAR). 2021;8(4):495-510.
24. Wang B, Asan O, Mansouri M. Systems approach in telemedicine adoption during and after COVID-19: roles, factors, and challenges. IEEE Open Journal of Systems Engineering. 2023;1:38-49.
25. Fitzpatrick PJ. Improving health literacy using the power of digital communications to achieve better health outcomes for patients and practitioners. Frontiers in Digital Health. 2023;5:1264780.
26. Ye J, He L, Beestrum M. Implications for implementation and adoption of telehealth in developing countries: a systematic review of China’s practices and experiences. NPJ digital medicine. 2023;6(1):174.
27. Isreal O. Infrastructure Barriers in Remote Rural Areas. 2025. https://www.researchgate.net/profile/Ilesanmi-Michael-2/publication/392557813_Infrastructure_Barriers_in_Remote_Rural_Areas/links/6848a8e58a76251f22ece3e8/Infrastructure-Barriers-in-Remote-Rural-Areas.pdf
28. Omweri F. A systematic literature review of e-government implementation in developing countries: examining urban-rural disparities, institutional capacity, and socio-cultural factors in the context of local governance and progress towards SDG 16.6. International Journal of Research and Innovation in Social Science. 2024;8(8):1173-99.
29. Luo TY, Zhu YQ. Pathways for the digital economy to drive urban-rural integration in Guangxi, China. GAS J Econ Bus Manag. 2024;1:162-74.
30. Shaw RJ. Access to technology and digital literacy as determinants of health and health care. Creative nursing. 2023;29(3):258-63.
31. Jena A, Bist L, Agarwal S, Bhuyan D, Abraham G, Borah K. Policy Innovation in Healthcare: Exploring the Adoption and Implementation of Telemedicine. International Journal of Statistics in Medical Research. 2025;14:136-44.
32. Pereira VC, Silva SN, Carvalho VK, Zanghelini F, Barreto JO. Strategies for the implementation of clinical practice guidelines in public health: an overview of systematic reviews. Health research policy and systems. 2022;20(1):13.
33. Eshchanov B, Abdurazzakova D, Yuldashev O, Salahodjaev R, Ahrorov F, Komilov A, et al. Is there a link between cognitive abilities and renewable energy adoption: Evidence from Uzbekistan using micro data. Renewable and Sustainable Energy Reviews. 2021;141:110819.
34. Otto L, Schlieter H, Harst L, Whitehouse D, Maeder A. The telemedicine community readiness model—successful telemedicine implementation and scale-up. Frontiers in Digital Health. 2023;5:1057347.
35. Mensah NK, Adzakpah G, Kissi J, Boadu RO, Lasim OU, Oyenike MK, Bart-Plange A, Dalaba MA, Sukums F. Health professionals’ readiness and factors associated with telemedicine implementation and use in selected health facilities in Ghana. Heliyon. 2023 Mar 1;9(3):e14501. doi:10.1016/j.heliyon.2023.e14501.
36. Nigatu AM, Yilma TM, Gezie LD, Gebrewold Y, Gullslett MK, Mengiste SA, et al. Health professionals’ technology readiness on the acceptance of teleradiology in the Amhara regional state public hospitals, northwest Ethiopia: Using technology readiness acceptance model (TRAM). Plos one. 2024;19(3):e0301021.
37. Gallant NL, Hadjistavropoulos T, Stopyn RJ, Feere EK. Integrating technology adoption models into implementation science methodologies: A mixed-methods preimplementation study. The Gerontologist. 2023;63(3):416-27.
38. Paramaraj A. Exploring the role of artificial intelligence in enhancing telemedicine accessibility, efficiency, and healthcare outcomes in rural Canada: University Canada West; 2025.
39. Hamilton D, Kohli SS, McBeth P, Moore R, Hamilton K, Kirkpatrick AW. Low Earth Orbit Communication Satellites: A Positively Disruptive Technology That Could Change the Delivery of Health Care in Rural and Northern Canada. Journal of Medical Internet Research. 2025;27:e46113.
40. Wang K-C, Huang P-S, Wang Y-L, Hoe Z-Y, Noor AA, Chen P-T. Bridging the gap: Healthcare practitioners' insights on overcoming Telemedicine barriers and optimal strategies for implementation. Technology in Society. 2025: 82:102899.
41. Gulyamov S, Narziev O. The Institutional and Legal Framework of Emerging Capital Markets: The Experience of CIS Countries. Psychology and Education. 2021;58(1):157-77.
42. Organization WH. Population health management in primary health care: a proactive approach to improve health and well-being: primary health care policy paper series. World Health Organization. Regional Office for Europe; 2023.
43. Iacovone L, Aviomoh H, Belacin M, Bossavie L, Cusolito A, de Hoyos R, et al. OnlineAnnexes.https://documents1.worldbank.org/curated/en/099112425121522769/pdf/P507816-6a394ec7-48f5-4827-a97f-f893fbe58305.pdf
44. Ursavaş ÖF. Unified Theory of Acceptance and Use of Technology Model (UTAUT). Conducting Technology Acceptance Research in Education: Theory, Models, Implementation, and Analysis: Springer; 2022. p. 111-33.
45. Schürmann F, Westmattelmann D, Schewe G. Factors Influencing Telemedicine Adoption Among Health Care Professionals: Qualitative Interview Study. JMIR Formative Research. 2025;9(1):e54777.
46. Jia H. Impact of digital infrastructure construction on the migrants’ utilization of basic public health services in China. BMC Health Services Research. 2024;24(1):761.
47. ABDRAKHMANOVA Z, DEMESSINOV T, JAPAROVA K, KULISZ M, BAYTIKENOVA G, KARIPOVA A, et al. Predictive modeling of telemedicine implementation in central Asia using neural networks. Applied Computer Science. 2025;21(2):82-95.
48. Marey A, Arjmand P, Alerab ADS, Eslami MJ, Saad AM, Sanchez N, et al. Explainability, transparency and black box challenges of AI in radiology: impact on patient care in cardiovascular radiology. Egyptian Journal of Radiology and Nuclear Medicine. 2024;55(1):183.
49. Nnabuife C. Improving Hospital Performance Using Technological Performance Strategies to Reduce Misdiagnoses: Walden University; 2024.
50. Mennella C, Maniscalco U, De Pietro G, Esposito M. Ethical and regulatory challenges of AI technologies in healthcare: A narrative review. Heliyon. 2024;10(4):e26297. doi:10.1016/j.heliyon.2024.e26297
51. Moonesar IA, Stephens M, Mazrouei KSA, Kiwanuka HD, Sergeevich GV. Telemedicine in the midst of the COVID-19 crisis: a case study in government and healthcare agility. J Healthcare. 2022;5(1):117–125. doi:10.36959/569/472.
52. Oughton E, Amaglobeli MD, Moszoro MM. Estimating digital infrastructure investment needs to achieve universal broadband: International Monetary Fund; 2023.
53. McGuire CM, Boskovic N, Fatusin BB, Ameh P, Reed T, Jethwani P, et al. Virtual Health Research Capacity Strengthening in Low-and Middle‑Income Countries: A Systematic Integrative Review. Annals of Global Health. 2025;91(1):14.
54. Pappas H, Frisch P. Leveraging technology as a response to the COVID pandemic: Adapting diverse technologies, workflow, and processes to optimize integrated clinical management: CRC Press; 2022.
55. Huseynli A. Effect of Resource Curse on Child Well-being in Resource-rich States, Specifically in Post-Soviet States. 2022 Washington University in St. Louis.
56. Intan Sabrina M, Defi IR. Telemedicine guidelines in South East Asia—a scoping review. Frontiers in neurology. 2021;11:581649.
57. Wibowo MF, Pyle A, Lim E, Ohde JW, Liu N, Karlström J. Insights Into the Current and Future State of AI Adoption Within Health Systems in Southeast Asia: Cross-Sectional Qualitative Study. Journal of Medical Internet Research. 2025;27:e71591.
- 摘要 ##plugins.themes.ojsPlusA.frontend.article.viewed##: 218 ##plugins.themes.ojsPlusA.frontend.article.times##
- pdf (English) ##plugins.themes.ojsPlusA.frontend.article.downloaded##: 176 ##plugins.themes.ojsPlusA.frontend.article.times##
